Organization
BAT JAC OF SOUTH CAROLINA
Active
Other names
POCAHONTAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ROBBINS RPH (PRESIDENT)
(304) 364-5636
Entity
Organization
Contact information
Practice address
105 DUNCAN RD, STE C, MARLINTON, WV 24954
(304) 799-4944
(304) 799-4995
Mailing address
PO BOX 148, MARLINTON, WV 24954-0148
(304) 799-4944
(304) 799-4995
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552366
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111733
PK
—
05
—
3810011534
—
WV
Enumeration date
03/10/2008
Last updated
06/24/2016
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